Provider Demographics
NPI:1134798721
Name:AYCOCK, ROBBY LANE (LCSW)
Entity type:Individual
Prefix:MR
First Name:ROBBY
Middle Name:LANE
Last Name:AYCOCK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 E ECHO DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-4891
Mailing Address - Country:US
Mailing Address - Phone:406-601-2578
Mailing Address - Fax:
Practice Address - Street 1:2227 E ECHO DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-4891
Practice Address - Country:US
Practice Address - Phone:406-601-2578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-375601041C0700X
MTBBH-LCSW-LIC-706951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical